Establishing Identity of ED Patients

[Jolie, BSN]

What is the procedure in your ED for verifying the identity of patients? Do you photocopy or scan a photo ID, take a digital photo for the medical record, or use some other method?

Has your department detected individuals misrepresenting their identity to obtain care under someone else's insurance?

[Sassy5d]

I don't have that situation as much as a find new pts, no Id and don't know their social.

They still get treated.. Although I don't know how they'd fill their rx if they fake it

[canoehead, BSN, RN]

I'm in Canada, and they show their health card. If they don't have their card we can look up a number, and then verify ID with questions about DOB, NOK, address. If they wanted to cheat us it would be fairly easy.

[Altra, BSN, RN]

Patients are asked for a photo ID if they are using insurance benefits. But a significant portion of our patient population has no insurance and so there is no reason to ask for ID.

I could rattle off a dozen or so semi-frequent flyers who are known to register under two or three different aliases (with SS numbers memorized for each) -- they do so to obfuscate the number of narcotic prescriptions they are receiving and/or to hide their whereabouts from law enforcement and associates.

[Penelope_Pitstop, BSN, RN]

I don't know how it works in our ED but I do know that once a fellow came in claiming to be a frequent flyer who had recently passed away. He always was admitted no matter what the complaint because every time was found to be in DKA, so I suppose this guy thought he could have the same thing happen? I don't know, but ED physician knew immediately it wasn't him and got the guy out.

If we find somebody trying to pass off another person's insurance card, we call the cops immediately - blatant identity theft and insurance fraud.

[sharpeimom]

I live I a town with a population of roughly 4,000 plus a population of approximately 8,000 in the outlying areas. When it's that small, you're either related to or know virtually everyone. You went to school with one generation and can recognize both prior and future generations by their looks alone. Weird, but true.

Our ER greets people by name, knows who has insurance, who doesn't, who is on Medicare or Medicaid, and who are without any coverage. A fairly usual greeting is something like, "Hi Mrs. ___, do you have your card with you today or shall I look up the number?"

They know which people or family members are troublemakers and have the police on speed dial ad they hit the button automatically when certain people come in before they ever get to check-in.

Kind of a strange system but it seems to work somehow.

[Adenosine6]

Simple:

Ask for ID of any form; if none (highly suspicious) then you can contact the police if you have reasonable doubt (drug seeking behavior) if the patient is committing fraud. By law in California you must keep some type of ID on you at all times.

Real Life examples:

1) pt comes in via ambulance "Kidney Stone" pain, I remember this patient months ago from a tattoo I recognized. My memory flashes to me "Drug seeking behavior, he will cut himself somewhere and place a drop of blood in the urine sample" I have him a chance to confess his true name; he didn't, I called the police. He then Eloped

2) pt comes in via ambulance, another nurse recognizes him as a pt before, but pt gives a different name. Asked him first to clarify, he denies allegations. Called police and they found his correct name and sited him for fraudulent behavior.

By law in California you must keep some type of ID on you at all times.

Untrue.

[Sassy5d]

Unless u know someone is lying, (frequent flyer) how do u call the police? Half my shift would be police reports

[Altra, BSN, RN]

Ask for ID of any form; if none (highly suspicious) then you can contact the police if you have reasonable doubt (drug seeking behavior)

Really - I will not be calling police because my patient who has been homeless or living "off the grid" for a long time doesn't have ID.

[CodeteamB]

To be honest this falls into the category of things I don't care that much about. We have it happen from time to time, generally someone who doesn't have coverage in our province and truly needs medical care. We make a note of it, and if someone recognizes the patient as not being who they say they are (and they know for certain) we might follow it up. It doesn't happen often enough to be a systemic problem, and generally doesn't make a big difference to the plan of care.

We also get patients who are completely unidentifiable. We treat them anyway and sort out who is paying later. If a patient has medical need I don't worry too much about the coverage.